Retinopathy of prematurity screening: evaluation of a first screening

Purpose: Retinopathy of prematurity (ROP) screening concerns preterm infants born before 32 weeks of amenorrhea and/or weighting less than 1500 grams. First screening occurs usually 4 to 6 weeks after birth and always after 31 weeks of amenorrhea. The purpose of this study was to investigate the number of examinations performed before the first signs of retinopathy, in order to determine the best time for first screening.Methods: This retrospective study enrolled preterm infants born before 32 weeks of amenorrhea and/or weighting less than 1500 grams in the University Hospital of Dijon, France, between 11/15/2012 and 12/31/2013. All preterm babies benefited from a ROP screening by fundus photography with a wide field camera. First screening was realized 4 to 6 weeks after birth and after 31 weeks of amenorrhea. All photographs were analysed. Population characteristics, number of examinations before first signs of retinopathy, term at first examination, at first signs of retinopathy and at the most severe signs of retinopathy were noted.Results: Hundred and eight preterm infants were enrolled; 33 were affected by ROP. Median [IQR] term was 29.6 [27.0 ; 31.0] weeks of amenorrhea. Median weight was 1118 [915 ; 1431] grams. Median number of examinations in preterm infants with ROP was 7 [4 ; 9]. Median term at first screening, at first signs of retinopathy and at more severe signs of retinopathy were 31.7 [30.9 ; 32.1], 33.7 [32.3 ; 35.0], 36.9 [35.6 ; 37.9] weeks of amenorrhea, respectively. Median number of examinations before first signs of retinopathy was 1 [1 ; 2]. In 25 preterm infants weighting less than 1000 grams, median term at first signs of retinopathy was 33.3 [32.3 ; 34.6], versus 34.8 [34.3 ; 35.2] in 8 preterm infants weighting more than 1000 grams (p=0.03).Conclusions: In ROP, the time of first screening is not well defined. According to our series, a first screening at 33 weeks of amenorrhea seems optimal